Curing the Country's Second Most Prevalent Disease
By Samuel Yee, DDS

Did you know that PERIODONTAL DISEASE ranks second to the COMMON COLD as the country's most prevalent disease? More than 75 percent of all Americans have periodontal (gum and associated bone) problems. This is typically caused by the plaque buildup from inadequate brushing and flossing and a lack of professional care. In fact, 40 percent of adults do not visit the dentist on a yearly basis. The research aimed at reversing the disease process, involving the gums, bone, and whole body, has lead to new techniques and materials.

Chemotherapeutics involving oral rinses and antibiotics have been successful in treating the soft tissue component of periodontal disease. The oral rinse typically prescribed is Peridex. This is a clorohexidine gluconate mouth wash. It will deactivate most of the bacteria causing gingivitis (gum inflammation). It works so well, that we are using this oral rinse prior to performing gum, implant, or oral surgeries. The group of antibiotics commonly used is tetracyclines. This antibiotic will latch on to the calcium in the jawbones preventing bacterial invasion, due to its affinity for calcium,. There are also newer techniques involving doxycycline, which is placed painlessly under the gums. This has worked so well that periodontal surgery may be completely eliminated!

Mechanical therapeutics, the first treatment of choice, involves cleansing and smoothing of the root surfaces and curettage of the diseased gum tissue around these roots. Current research shows periodontal disease will deteriorate the major organs of your body. Therefore, the elimination of the disease—causing bacteria will dramatically improve the health of gum tissues and the health of your entire body. So the old proven technique is the first treatment of choice especially in conjunction with the newer chemotherapeutic techniques.

Lasers have recently been used in dentistry and the benefits are numerous. Not only can we sterilize the gum tissues, we can also desensitize the root surfaces. We can also perform certain types of gum surgeries without anesthetics (numbing shots).

Biomedical therapeutics has enabled us to repair the damaged bone, which surrounds the roots. Various materials and techniques are used in an attempt to stimulate bone formation:

1. Gore-Tex (a teflon-type fabric) is used to keep the gum tissue from invading a bony defect. This allows the bone to grow into the defect. Artificial collagen, resorbable mesh, and sterile calcium sulfate are also used in a similar manner. These materials eliminate the need for a second surgery, which is required for the Gore-Tex technique.
2. Bone transplant from another site (donor site) to the area of bony defect (recipient site). Normally, this is very successful; 
however, it requires two surgical sites instead of one.
3. Sterilized bone grafts (from donors) are used to fill defects left by the periodontal disease. This donor bone provides a matrix and a calcium supply for the jawbone to growth.
4. Artificial bone grafts made of calcium crystals, similar to our bone, can also provide a matrix for bone growth.
5. Calcium phosphate cements can fill the defect, which becomes a solid graft within 15 minutes. This is similar to sterile plaster, except the calcium phosphate crystals are similar to the bone crystals. Most other grafts are granular and may allow the gum tissue to invade between the particles.
6. Current studies on Bone Morphogenic Proteins show. These are the proteins, that tell the body to make more bone. If we can manufacture this material in large quantities, we may be able to solve a variety of bony defects.

As technology improves so does the success of our treatments. “Take good care of your health. It's all you really have!”